Job Description

Job Description

Job Description

Description:

Job Description :

We are looking for a reliable and compassionate Home Health Medicare / Episodic biller for home health to join our team.

Why Lifecare Home Health Family?

Join our team at Life Care Home Health Family to be a part of a company that strives to provide the best care for our patients while building a team of dedicated employees. If you want a company that appreciates your skills, compassion, and heart, then Lifecare Home Health is the place for you! We take pride in not only providing excellent care to our patients but also creating a positive team environment with employee support.

We provide,

Benefits eligibility now starts the 1st of the month following employment.

• Competitive base Pay
• Medical, Dental, Vision
• 401 (K), Flex Spending
• Life Insurance
• Short- Long-Term Disability
• PTO
• Team Events
• Recruitment Incentive Program
• Continuing Education Training
• Employee Recognition Programs
• Performance Incentives
• Family Team Environment

General Summary:

The Regional Home Health Medicare Billing Specialist is responsible for timely and compliant Medicare Home Health billing and reimbursement for their designated region. The position will work directly with the Home Health Revenue Cycle Director, Billing Compliance Coordinator, Agencies, and Intermediaries to facilitate a fluid process of billing claims timely and successful. This position will prepare, audit, and submit claims electronically for appropriate payment. This position will be responsible for following up on outstanding Medicare claims and taking the appropriate action to ensure timely payment is received.

Patient Population: N/A

Essential Functions :

1. Collect all the necessary information to prepare Medicare claims, coordinating with agencies when appropriate.
2. Bill and submit clean claims to Medicare electronically and follow up with the Intermediary.
3. Process, collect, and manage Medicare account payments.
4. Monitor FISS daily, report totals for requested status locations, and monitor ADR locations.
5. 5. Research, correct, and re-submit rejected and denied claims.
6. Utilize the revenue cycle management tool to follow up on corrections and report adjustments. Address and resolve “T” status claims daily in relevant FISS.
7. Monitor and maintain assigned accounts. Review billing reports to maintain accurate AR balances. Document all follow-up completed on claim outstanding balances until final resolution is reached.
8. Keep accurate and orderly records for all billing and accounts receivable activity.
9. Pre-billing audits as assigned.
10. Proactive in identifying potential reimbursement issues while ensuring effective problem resolution.
11. Coordinate with the Agency and Billing Compliance Coordinator on any relevant process issue impacting billing to establish a resolution.
12. 12. Report any billing issues that develop into trends to the immediate supervisor.
13. Answer questions from patients, agency staff, and insurance companies.
14. Interpret and process Explanation of Benefits when needed.
15. Make outbound calls professionally while maintaining and improving customer relations. 16. Report any Medicare credit balances each quarter.

Experience:

• Required, Home health billing experience
• Required, Medicare billing experience.
• Preferred, Kinnser experience. Experience with AbilityEASE and Palmetto GBA OPS a plus.

Skills:

• Ability to communicate effectively both verbally and in writing
• Excellent customer service skills
• Medicare and Managed Medicare billing and denial management skills
• Excellent PC skills, including Medicare DDE (FISS), Email, Internet Research, Word Processing, Spreadsheets, PDF and Patient Accounting software systems knowledge (preferably Kinnser)
• Reviews and maintains reports and records to ensure accuracy
• Knowledge in accessing the Medicare system, capable of direct edit and/or entry of claims.
• Claims preparation and audit, including prebill audits for billing compliance
• Knowledge of Medicare Secondary Payer(MSP) regulations and claim submission
• Detail oriented, effective in problem resolution and escalation
• Able to organize duties and functions in a highly effective manner to achieve productivity and quality standards
• Knowledge of CMS regulations and publications for Home Health Agencies

Education:

• High school diploma or equivalent.

Licensure/Certification: N/A

Physical Requirements:

• Prolonged sitting, standing, and walking required.
• Ability to handle stressful situations in a calm and courteous manner at all times.
• Requires working under some stressful conditions to meet deadlines and Company needs.

Environmental/Working Conditions:

• Works primarily in an office environment.

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